Healthcare Provider Details

I. General information

NPI: 1407554207
Provider Name (Legal Business Name): BRAIN & SPINE WELLNESS CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2023
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 21ST AVE S STE 203
NASHVILLE TN
37212-4927
US

IV. Provider business mailing address

2300 21ST AVE S STE 203
NASHVILLE TN
37212-4927
US

V. Phone/Fax

Practice location:
  • Phone: 615-463-0550
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: KATHERINE AFZAL
Title or Position: OWNER
Credential: DC, DACNB
Phone: 615-463-0550